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  Fundamental MedicineTeresa Gryder, ND

Naturopaths Know about Aristolochic Acid Toxicity

11/8/2017

 
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​The photograph above is a wild ginger plant in the genus Asarum. I photographed it last week in the woods near my father's house. Don't eat it. We know this. Some plants are poison. Naturopaths know about aristolochic acid because it is part of our training in botanical medicine.

Medicine in the US today is as polarized as our politics, and just as full of talking points and bald faced lies. I find it infuriating and frustrating. Today I read a hit piece attacking naturopathic doctors.
 It claimed that we push herbs that contain aristolochic acid (AA). AA is a known carcinogen in the bladder and kidneys, and a new study suggests that it's causing a lot of liver cancer too. It really ticks me off when headlines say we push people to take poison. Not so. We are here to guard against such mistakes.

Chinese herbal products have often been found to contain toxins, and to be mis-labeled or not labeled at all. Herbs containing AA can be found in Chinese weight loss formulas, among other places Here in the good old US we may complain about the shady politics in the FDA, but at some level they really are trying to protect us. They're doing better than the Chinese authorities, far as I can tell.

There's been an incredible increase in the wealth of the Chinese middle class in the last 25 years. Suddenly people have jobs, cars, and disposable income. They are eating more sugar than they ever have before, and they are getting fat, even getting diabetes. The Chinese are looking more and more like US.

Combine their new obesity, disposable income, and good supply of poorly regulated herbal products, and you can understand why the Chinese are getting cancer from AA. Lots of other people in Asia, like the Taiwanese, are having the same problem.

We've known about AA for a long time. The FDA issued a warning about it in 2001 which is when it came onto a lot of people's radar.

If you would like to know if an herbal formula or a supplement is safe to take, there is no one better to consult than a naturopath. We study on which herbs are useful and which are dangerous.

It is true that the vast majority of herbal products are not very well tested. You have to do the research to find out which ones are good, or ask a naturopath. Some companies have excellent quality assurance standards, and some do not. If you are going to take a product, you want to know if it contains what it says on the label. You also want to know that it does not contain anything toxic. Third party testing of products is expensive and most companies don't do it. If you buy the cheapest herbs you can get, you are probably choosing the ones that haven't been checked. Just so you know.

The people who are dedicated to the project of smearing alternative medicine don't know much about it, but that doesn't slow them down. It has become disgustingly normal, especially online, to just say whatever you want as if it were true, and keep saying it until the dimwitted come to believe you.

Don't let them brainwash you. Keep your wits sharp. Gather information and challenge your own assumptions. There is disinformation on all sides, and medicine is as rich a medium for BS as politics.

Just because something is natural does not make it safe.  Just because something is herbal does not make it dangerous. If you're going to experiment with herbs, do your research--or get some help from someone who has. And don't buy imported herbs online. Please.

Ten Tips for Drinkers (You Know Who You Are)

2/2/2017

 
  1. Never mix alcohol and tylenol.  Tylenol’s other names are acetaminophen and paracetamol.  It’s a common ingredient in over-the-counter cold medications (Nyquil), allergy meds, and RX pain meds like Vicodin and Percocet.  People can accidentally take too much because it’s in so many different products.  Tylenol is the world’s leading cause of fulminant liver failure, meaning severe, acute, and potentially fatal liver failure.  Mixing alcohol with tylenol is the kiss of an ugly death.  When you have a hangover and are searching the cabinet for something to treat your headache, use aspirin or ibuprofen or naproxen.  They're not quite so dangerous.
  2. Hydrate.  Most hangover symptoms are caused by dehydration.  Alcohol is a potent diuretic.  You might know this from the way that one beer makes you pee like you drank two.  Instead of taking pills for a hangover, guzzle water.  And if you know you’re going to imbibe, drink water before you even start.
  3. Take lots of vitamin C.  Especially after a binge, vitamin C helps neutralize the toxic breakdown products of alcohol metabolism, and it helps reverse fatty liver disease.  How much is lots?  Four to twelve grams a day, split up into lots of doses.  At the high end of this dose range it will cause diarrhea, but if you really binged, you will already have diarrhea.
  4. Be nice to your Gut.  Drinking alcohol causes Leaky Gut. This is when food particles leak through your gut lining instead of getting processed through the cells like they should. Leaky gut compromises your immune system and is a common factor in autoimmune diseases.  So eat a healthy diet with fruit and vegetables, and eat fermented foods like live yogurt, kefir, kraut or kimchi.  And get help if your gut isn’t working right.
  5. Know when to call 911.  If a heavy drinker suddenly spits up blood, it’s time to call.  Alcoholics can die when blood vessels in their esophagus burst, but they can live to see another day if you call early enough.  If the kids have had red bull drinks (alcohol and caffeine together) and start acting delirious, it’s time to call.  Caffeine prevents people from passing out so they’re more likely to reach a blood alcohol level that is really poisonous. Oh yeah, and definitely get help if someone turns yellow. Their eyes turn first.
  6. Eat FISH. It’s good for your brain.  Heavy alcohol consumption can cause dementia, and consuming lots of good omega 3 fats helps prevent the brain from degenerating.  So learn to love those fatty fishes—or start taking fish oil.
  7. Drink coffee.  You think I’m joking.  Coffee helps reduce liver damage caused by alcohol and by hepatitis.  It’s a powerful effect. Coffee also helps prevent dementia for other reasons.  So enjoy your cuppa joe!  It will help you sustain your Great Satan lifestyle longer.
  8. Sunbathe.  Large expanses of skin in bright sunshine makes hundreds of thousands of IU’s of vitamin D in just 15 minutes, so get a natural dose any time you can.  If you can never expose your white expanses, or if you live where the sun don’t shine, take a vitamin D supplement.  It helps prevent cirrhosis.
  9. Take a B Complex.  Thiamine is vitamin B-1, and a deficiency of this vitamin causes the severe memory loss that affects alcoholics.  You need all the other B’s too, so don’t take just one kind of B.  Take a quality B-complex in doses as big and regular as your drinking, and you’ve headed off this deficiency at the pass.
  10. Don’t be stupid.  I know it’s hard not to be stupid when you’re drunk but plan ahead when you’re not drunk so that you have a ride, a coat, and a place to crash.  Your body wastes heat after heavy drinking, so you can feel warm while you are descending into hypothermia.  Take a little extra care if you’re feeling reckless or have a tendency to behave impulsively.  Get help if you’re really headed down the drain: we need you.  

How to Swallow a Fistful of Pills

6/10/2015

 
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Swallowing isn’t easy to do when you’re thinking about it.  When you eat it happens automatically.  When you have a fistful of medications or supplements to get down, it can be unpleasant.  There are few things worse than getting a large bitter pill stuck in your craw.

A 2015 study showed that 3/10 adults averaging age 50 would rather die than take a daily pill for the rest of their lives, and another 1/5 would gladly pay $1,000 to avoid having to take a daily medication.  If taking pills is this undesirable, why don’t more people make the diet and lifestyle changes that would free them from pill taking?  The answer is of course complex.  During our lives, almost all of us will choose to swallow pills, if not longterm, at least long enough to give us relief from a temporary ailment.

At some time in your young life, someone asked you to swallow a pill.  Children don’t know how, and are usually given chewable or liquid medicines until they learn.  In old age it gets harder to swallow pills, so we end up looking for liquids and chewables again.  In the meantime, between childhood and old age, we’re supposed to be able to swallow them.  There are tricks.  Here is a primer.

There are two main kinds of pills that you’ll be asked to swallow; capsules and tablets.  Capsules are a little cylinder usually containing a powder.  Usually they float, though some of them sink.  Tablets, on the other hand, are made of a substance that is caked together into a mold.  They can be any shape but smart designers make them round or oblong.  Capsules are easier to split, and they usually sink.

It helps to know if your pills are floaters or sinkers.  It’s easier to swallow the same kind together.  You can test each pill in a glass or water, or in your mouth, to detect if it floats or sinks. Putting pills in a glass is a good way to see how long it takes the pill to dissolve, too.  (Aside: If you put a pill in a glass of water and it doesn’t dissolve in a day’s time, you probably aren’t getting anything out of it.)  Pay attention to which pills float or sink, and take the same kind together.

SWALLOWING PILLS THAT SINK

Sinkers are the easiest to swallow because they behave like food does, sitting on your tongue.  All you have to do is tilt your head back a little bit and let them slide to the back of your tongue, and then take a sip of water and swallow it.  It is also possible to simply place the pill(s) at the back of the tongue using your hand, then drink.  They will go down.

SWALLOWING PILLS THAT FLOAT

Floaters are tricker.  They are easiest to swallow with a bite of pre-chewed food.  If you need to swallow them with liquids, here is a trick.  With the pill(s) and a modest swallow of water in your mouth, assume your best military posture, with your neck long and chin tucked.  The pills will float to the roof of your mouth (your soft palate), and the good posture with chin tuck helps them move to the back.  When you feel the pills on the roof of your mouth, distract yourself and swallow, or take another sip to push them along.

WHEN YOU CAN’T SEEM TO MAKE YOURSELF SWALLOW

This usually happens when you are trying to swallow too many pills at once, or a pill that is so big that it scares you.  It floats around and threatens to dissolve and taste horrible.   It’s OK to swallow pills one at a time until you are ready to try more.

WHEN A PILL DOESN’T GO DOWN

Usually what happens, at least in younger folks, is that the pill gets stalled out in the throat somewhere, and the natural peristaltic movements of the esophagus bring it back into your mouth.  Slippery pills (like gel caps) slide back up easily.  Grainy or sticky tablets can get hung up and make you gag.  When a pill feels stuck, keep swallowing.  Take swallows of your drink or bites of of food, and keep doing it until it goes all the way down.  Some pills (like osteoporosis drugs) can hurt your esophagus if they get stuck.  Your doctor will warn you if your medications have this risk.

DISTRACT YOUR MOUTH

To swallow a bunch of pills at once, put them all in your mouth with a bit of water, and then using your tongue place one pill between your teeth and gums, and swallow the rest.  Something about storing the one pill distracts your mouth enough to get the rest of the swallow to happen normally.

TAKE PILLS WITH BITES OF FOOD

Liquids are harder to swallow than food.  Pills that are best taken with food are also easiest to swallow with food.  Basically you take a bite of food, and chew it until it is thoroughly chewed and ready to swallow.  Then pop a pill or three in there and swallow it.  You can chew a little more if needed to feel ready to swallow it, but try not to break up the pills.

There are more tricks, but those are the basics.  If you are like me, and struggle with swallowing pills, you may need some tricks.  Good luck to you.  May you heal quickly and no longer need pills.  May you find the medicine you need in sunshine and laughter, and the nutrition you need in food.

Good Fats for Brain Health

5/12/2014

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Recent post by Dr Gryder at the Madness Medicine Blog.
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Plant (Phyto) Medicine: Wimpy vs Dangerous

6/27/2012

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I'm studying for boards these days.  We have a long list of herbal medicines we are supposed to know (in addition to a 3x longer list of Rx meds).  I consider this to be my opportunity to sort out which plants I want to use in my practice.  I am studying up on each one, and deciding if I think the evidence is sufficient for me to recommend it.  

On the internet I find two dominant claims about phytomedicine. 1) Herbs don't do anything useful, are inert or inactive, and 2) Herbs might cause you grave harm and could interact with your medications and kill you.

The conflict between these two claims is amusing to me.  If plant medicine is so worthless, then why isn't it harmless?  If herbs don't do anything, then why are we so worried about them?  And on the flipside, if a plant can cause drastic changes to your physiology and interact dangerously with your medications, how can it be inert and wimpy?

Plant medicine is more useful than conventional practitioners want to admit.  Many would like to convince their patients to avoid plant medicine entirely, because it is unpredictable and unknown to them, and so seen as dangerous instead of helpful.  It is my observation that conventional practitioners are extremely concerned about interactions between herbs and medications, while they very rarely check for interactions among the medications that they prescribe.  I have studied cases in which my patients or family were prescribed many meds that are processed by the same pathways in the liver.  Their physiology must have been significantly altered in ways that have certainly not been studied.  Show me a drug study that gives four or more medications and measures their combined effects!!  Yet it is no problem finding a baby boomer on that many meds.  When people complain that herbal medicine hasn't been studied enough, remember that pharmaceutical medicine is mainly studied by the people who wish to profit from it, and that negative results are routinely swept under the carpet.

One criticism of plant medicine rings very true, and that is the inconsistency of the contents of the supplement.  Plants grow differently in different places, are harvested with varying levels of care, different parts of the plants are used, different methods are used in processing them, and different kinds and amounts of fillers are added.  There is tremendous variability in the amount and quality of the plant matter in any given capsule.  Some contain little, if any, of what they claim to contain.  There are higher quality supplements available to licensed Naturopaths, and we trust them more, but I for one intuitively trust plants more than pills.

If you can't be sure of the contents of a capsule you bought on the internet, what can you be sure of?  I am sure that plants contain more constituents than we have researched, more than we know about.  I am sure that the whole plant often has actions that one of its components does not.  All the constituents in a given plant (or combination of plants) may have a synergistic effect that we never completely understand, because of the complexity of plant matter and life itself.

So I operate on a few assumptions, based on experience and centuries-long traditions.  In most cases fresh herbs are more potent that dried and processed ones. There are exceptions when processing removes a constituent that is harmful, or when a concentrate or extract really is better.  But not always.

I am pretty sure, from a commonsense gardener's point of view, that I trust my dirt more than dirt in China.  I happen to live where the soil is good and many plants grow.  If I lived in the desert, I'd want to know that my plant medicine came from a clean place.  If I'm going to buy herbs, I'd like to know what kind of care was put into its selection and care, where it grew, how it was harvested and processed, stored and delivered.  I want a minimum of fillers, and I want to know what fillers they are.  I want to know it all.

Most of the herbs on our study list have a very long list of traditional indications, and just a tiny little bit of actual science on a few of their constituents.  A few of them have plenty of science, usually the poisonous ones.  Dr Google sends warnings about avoiding this plant, because it can kill you.  Tell me this: what pharmaceutical medication is not dangerous if overdosed?  They all are!  Toxic herbs are the most potent medicine available to an herbalist.  The trick is in knowing how to dose them appropriately.  The use of toxic herbs is not appropriate for lay people to attempt without guidance, and so the warnings are welcome.

Plant medicine is both more powerful than we realize, and more benign than pharmaceutical medications.  Its reputation should not be marred by the offenses of a few profit-seeking supplement companies.  We are designed to eat plants, touch plants, live in harmony with plants.  When you sip your coffee, or put ketchup on your burger, you are partaking of plant medicine.  Look out!!  It might make you feel better.
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Eating Fish: Healthy or Toxic?

7/25/2011

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There's a debate raging about fish---whether or not we should eat it, what kind, and what we should do about the toxic mercury that contaminates much of the world's fish supply.  There are some who say don't worry about it, fish is so good for you that you should just eat it and don't worry about the mercury.  There are others who say that fish is so dangerous that you shouldn't eat any, and that you should supplement fish oil that has been tested and is free of mercury instead.  There is no doubt that most Americans don't get enough omega 3 fatty acids, and that we can get them from eating more fish.  So where do I fall?  Somewhere in the middle.  Because really, like all diet and lifestyle choices, it is a personal decision.

For the last century fish have carried increasing levels of mercury and other contaminants.  Carnivorous fish have more, because many toxins bio-accumulate.  Equatorial fish have more, because there are more people and hence more pollution around the midsection of the planet.  Interestingly, since the economy took a dive a few years back, the mercury levels in fish have declined.  Some say that it is because there is less coal being burned in China.  Most environmental mercury comes from coal smog.  All this is debatable, but the fact that there is mercury in fish, and that mercury is bad for people, especially people's brains, is very well documented.

So what do I do?  I eat fish 1-2 times a week, and supplement fish oil, ideally every day, though I often fall short of that goal.  I choose fish that are less likely to have a high mercury load---less carnivorous fish, smaller fish, more northern fish, instead of tuna from near the equator.  I supplement zinc, because being replete for good metals reduces one's absorption of bad metals when introduced.  And I support my liver's detoxification mechanisms in many ways, not the least of which is eating sulfur rich foods like cilantro and garlic.  I don't know exactly what balance will be right for you, but it is worth being conscious of the toxic challenges that may be in your food, and acting intentionally about it.

Here is a site where you can find out how much of what is in the fish you eat:
http://www.howmuchfish.com/

Edit 11/28/11: I just heard that fish have high enough selenium levels to bind up most of the mercury that they ingest, and possible render the majority of it non-absorbable to us.  I have not confirmed this yet, but it brings up the question: would repletion for selenium benefit humans with regard to avoiding mercury toxicity?  I do know that most humans are deficient in selenium.  And I also know that selenium is a key cofactor in the activation of thyroid hormone; if you don't have enough selenium, you will feel tired.  So it's worth considering both selenium and zinc as nutrients to bulk up on if you want to eat fish.  More updates as I learn more!
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Coffee Interferes with the absorption of Thyroid Medication

1/23/2011

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Here's the list of stuff that is so far known to
Decrease your Absorption of Thyroid Medications:

*coffee (decreases absorption by about 1/3)
**antacids containing aluminum hydroxide
***ferrous sulfate (you know, iron supplements)
****calcium carbonate (calcium supplements and high calcium foods)
*****soy protein shakes 
(what about everything ELSE that has soy protein isolate in it?)
******Raloxifene/evista (pharmaceutical for osteoporosis)
*******chromium picolinate (supplement often given to diabetics)

The full scoop including abstracts for the studies can be found at:
http://www.denvernaturopathic.com/thyroidinterference.htm.  There you will also find the abstract of a study that demonstrates that taking your thyroid medication at bedtime may be more effective than taking it first thing in the morning.

Furthermore, I confess that I learn more great new stuff from Jacob Schor's email newsletter than from most of my professors.  You too can get on his email list at: http://www.denvernaturopathic.com/ .
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    Author: Teresa Gryder

    Integrative Physician and Student of Life, Medicine, and the River.

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